To protect their companies and their shareholders, disability insurance companies have made it difficult for the average person to file a claim and receive the benefits they signed up for. When a person successfully claims disability insurance benefits, it is long-term and very expensive for companies.
Because of the laws that apply to disability insurance policies, there are no penalties if companies deny or delay claims. If you are fighting for your disability pension and it takes a year of losing your home and life savings, there is no penalty or penalty for the disability insurance company. If you win a court case, you get what they were originally supposed to pay you. The only thing insurance loses is their in-house office time, while people who are ill or injured can lose a lot more. That’s why it’s important to know as much as you can about disability insurance, the process of applying, and the process of fighting for a claim in order to protect yourself.
Insurance companies employ many medical professionals to investigate claims. They have staff of nurses and doctors who do nothing but read medical records and review diagnostic tests all day to file lawsuits against claimants. We have seen many cases where the medical examiner sees only a small part of the person’s medical record – important documents that clearly demonstrate a serious illness are omitted. Is this intentional or just bad record management? It’s hard to know, but the bottom line is that disability insurance beneficiaries are struggling to have their full medical records checked.
Insurance companies often use in-house medical personnel to contact treating physicians, review claims, and write inaccurate letters to build cases against claimants. A typical scenario: The medical worker calls the doctor’s office, talks about the claimant, and then the insurance company worker sends a letter to the doctor’s office confirming the call. The problem is that the letter is not entirely accurate and does not reflect the conversation that took place. Some facts are twisted, others are left out entirely. The crucial part is this: The letter will include a statement that says, “If we don’t hear from you by (a certain date), accept the statements in the letter as fact.”
Doctors, office managers and their own staff are busy and responding to this letter is not their top priority. If no one replies, or if the reply comes after the date, the insurance company uses that as approval of the content of the letter, even if the letter is grossly inaccurate and contradicts every information in the patient’s medical record.
Today, it is cost-effective for insurance companies to use video surveillance to monitor applicants’ activities. If you’ve made a claim and a van or truck shows up on your block that doesn’t appear to have any discernible license plates, or workers taking out equipment or making a delivery, there’s a good chance surveillance is taking place. If you have a disability like fibromyalgia where you can’t get out of bed some days and feel almost normal other days, video surveillance only shows you on a good day. This can lead to a difficult situation. However, if your medical records reflect the unpredictability of your illness, you have a better chance of contesting your disability insurance claim.
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